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Premature deciduous tooth loss: a rare case of detrimental sequelae to the permanent dentition

From Volume 16, Issue 2, April 2023 | Pages 79-81


Early loss of deciduous teeth can be associated with loss of space, tooth displacement, centreline disturbance, tooth impaction and ectopia. Its inevitability, unless monitored accordingly, among patients makes it pivotal that practitioners are aware of the detrimental effects, so they are able to consider these in the patient's management. This report presents the case of an 18-year-old patient who experienced tooth impaction and significant first premolar root resorption following the premature loss of deciduous second molars.

CPD/Clinical Relevance: The orthodontist should be aware of the potential for detrimental sequelae of early primary tooth loss and subsequent tooth impaction, and ensure these are appropriately assessed and investigated in order to incorporate these into a patient's management plan.


Premature deciduous tooth loss due to caries or trauma is prevalent among children, with extraction of decayed teeth being the most common reason for children aged 5–9 years in the UK to receive a general anaesthetic.1 For both the referring general dental practitioner and receiving orthodontist, it is prudent to be aware of the potential for detrimental sequelae to the permanent dentition that may result because of this.

Early loss of deciduous molars and canines has been associated with an increased risk of centreline disturbance,2 loss of space with ensuing risk of arch crowding, tooth displacement, impaction and ectopia.3 The second deciduous molar is regarded as the ‘key tooth’ in the primary dentition4 because its premature loss has been associated with a greater reduction in leeway space than the first deciduous molar, and is therefore considered to have a more significant impact on malocclusion in the permanent dentition when not managed adequately.4,5,6

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